A Review of: “Adolescent Sexuality: A Historical Handbook and Guide” edited by Carolyn Cocca

Two well‐cited studies (Fisher, 1980; Schwartz, 1973) have suggested that people with negative emotional orientations toward sexuality (i.e., “erotophobia” or “sex guilt”) have difficulty learning contraceptive information. However, a recent laboratory study (Goldfarb, Gerrard, Gibbons, &; Plante, 1988) has raised doubts about this conclusion by demonstrating that erotophobic women can learn contraceptive information if they are exposed to it. The current study was designed to further clarify the relationship between emotional orientation toward sex and ability to learn sexually relevant material. Specifically, it compared pretest and post‐test knowledge of contraception and AIDS in erotophobic and erotophilic students in a university class on human reproduction. While the results indicated that male erotophobics initially knew less, there were no knowledge differences between males and females or erotophobics and erotophilics at the end of the course. Thus, these results support the conclusion that erotophobics are capable of learning sexual material if they are exposed to it. The implications of these results for educational strategies for decreasing unplanned pregnancy and sexually transmitted diseases are discussed.     

Predicting Loss of Life in Cases of Dam Failure and Flash Flood

This paper improves upon previous attempts to predict loss of life (LOL) from severe flooding events. An expression for LOL in terms of warning time (WT), the size of the population at risk (PAR), and the forcefulness of the flood waters (Force) is derived from the historical record of dam failures and flash flood cases via logistic regression. There is no evidence for an effect of prior flooding experience or an interaction between WT and PAR, as has been suggested elsewhere. Guidelines are suggested for the proper use of the final equations and the findings are discussed in relation to a theoretical model of flood fatalities.     

Occupational Advantage and the Impact of College Rank on Labor Market Outcomes*

Most analyses of the effects of college rank on labor market outcomes focus on its average impact across sub-populations and employment situations. The framework adopted in this paper, however, suggests that the effects of college rank may vary by individual characteristics and type of job. Using data from the 1973 Occupational Changes in a Generation Survey, we test three hypotheses suggesting that occupational advantage, as measured either by family of origin or current position, is a significant determinant of capacity to convert increments in college prestige into labor market success. The findings suggest that where one went to college is especially consequential for (1) the occupational status of individuals from professional families; (2) the earnings of individuals from both professional and managerial families; and (3) the earnings of individuals in both professional and managerial positions. Overall, these findings tend to confirm the study's underlying hypothesis that aggregate analyses of college rank may be misleading when applied across sub-populations and employment situations.     

Factors affecting nonmedical participants' allocation of scarce medical resources

This study was designed to determine the factors that affect nonmedical participants' judgments in constructing a ranked waiting list for kidney patients requiring dialysis. Participants (N=167) were given a questionnaire that provided minimal demographic data about 16 hypothetical patients. Participants were requested to rank patients in order of priority for treatment. Each participant's personal demographic details were also obtained. Patients differed on four dimensions: gender, income, alcohol consumption, and religious beliefs, yielding a 2x2x2x2 design. The participants favoured for treatment included females over males, "poor" over "rich," nondrinkers over drinkers, and Christians over atheists. Results are discussed in terms of establishing democratic criteria and informing medical personnel on explicit factors which may affect their decision making, thus guarding against biases in judgment.     

Understanding dissociation in relation to child trauma,mental health needs,and intensity of services in child welfare: A possible missing link

Abstract

While there is limited research on the role of dissociation among children and adolescents, emerging evidence links child trauma history, dissociation, risk behaviors, and other negative outcomes among youth. This study examined dissociation in relation to mental health needs and intensity of services among a large sample of youth in Illinois child welfare, upon entry into care and in residential treatment settings. The Child and Adolescent Needs and Strengths (CANS), a comprehensive, trauma-informed assessment strategy and information integration/planning tool was the primary measure. This study included two overall samples of child welfare-involved youth, ages 3–18: at entry into care (N?=?27,737) and in residential treatment (N?=?5,758). Findings indicated that rates of clinically significant dissociation were generally highest among younger youth (under age 14) and among youth with more cumulative and severe trauma. Dissociative youth were significantly more likely to exhibit several risk behaviors (e.g., fire setting and self-harm) and mental health symptoms (e.g., psychosis and somatization). Those youth with significant dissociation at entry into care were more likely to be psychiatrically hospitalized, placed into residential treatment, with greater likelihood of placement disruptions within the 2 years following entry into care. Implications of these findings are discussed in terms of the value of identifying and assessing dissociation and other trauma-related symptoms that may be less recognized but can be linked to high-risk behaviors and other negative outcomes within child welfare and across child-serving systems. Understanding dissociation may be an important component of training, service/treatment planning, and clinical care within child-serving systems.     

Addressing the impact of trauma before diagnosing mental illness in child welfare

Congress set requirements for child welfare agencies to respond to emotional trauma associated with child maltreatment and removal. In meeting these requirements, agencies should develop policies that address child trauma. To assist in policy development, this study analyzes more than 14,000 clinical assessments from child welfare in Illinois. Based on the analysis, the study recommends child welfare agencies adopt policies requiring that (1) mental health screenings and assessments of all youth in child welfare include measures of traumatic events and trauma-related symptoms; (2) evidence-based, trauma-focused treatment begin when a youth in child welfare demonstrates a trauma-related symptom; and (3) a clinician not diagnose a youth in child welfare with a mental illness without first addressing the impact of trauma. The study also raises the issue of treatment reimbursement based on diagnosis.     

Seeking safer sexual spaces: queer and trans young people labeled with intellectual disabilities and the paradoxical risks of restriction

Young lesbian, gay, bisexual, and transgender (LGBT) people labeled with intellectual disabilities have unique sexual health needs that are not being met. Denial by others of their right to pleasure and the exercise of heightened external control over their sexuality are commonplace. Current research indicates that these youth are at heightened risk for compromised sexual health. This study aimed to explore the ways in which social and environmental conditions influence vulnerability to adverse sexual health outcomes for this population. We used a community-based research approach to conduct qualitative interviews and focus groups with 10 young LGBT people (aged 17-26) labeled with intellectual disabilities. Participants reported multiple limitations on their autonomy that resulted in having sex in places where they did not feel comfortable and were unlikely to practice safer sex. Attempts by authority figures to protect youth through limits on their autonomy may be unintentionally leading to negative sexual health outcomes.     

Vaginal Dryness and Beyond: The Sexual Health Needs of Women Diagnosed With Metastatic Breast Cancer

While research on the sexual health of women with early stage cancer has grown extensively over the past decade, markedly less information is available to support the sexual health needs of women diagnosed with advanced breast cancer. Semistructured interviews were conducted with 32 women diagnosed with metastatic breast cancer (ages 35 to 77) about questions they had concerning their sexual health and intimate relationships. All participants were recruited from a comprehensive cancer center at a large Midwestern university. Three themes were examined: the role of sexual activity and intimate touch in participants' lives, unmet information needs about sexual health, and communication with medical providers about sexual concerns. Findings indicated that sexual activities with partners were important; however, participants worried about their own physical limitations and reported frequent physical (e.g., bone pains) and vaginal pain associated with intercourse. When women raised concerns about these issues in clinical settings, medical providers often focused exclusively on vaginal lubricants, which did not address the entirety of women's problems or concerns. In addition, women diagnosed with metastatic breast cancer reported needing additional resources about specialized vaginal lubricants, nonpenetrative and nongenitally focused sex, and sexual positions that did not compromise their physical health yet still provided pleasure.     

When,If, and How: Young Women Contend With Orgasmic Absence

While cultural ideas about “healthy” and “fulfilling” sexuality often include orgasm, many young women do not experience orgasm during partnered sex. The current study examined how women described this absence of orgasm in their sexual experiences with male partners. We examined interviews (N = 17) with women ages 18 to 28 and focused on their ideas about orgasm and their explanations concerning when and why they do not orgasm. We explored three themes that illustrate the strategies young women use to contend with orgasmic absence: (1) What’s the big deal?; (2) It’s just biology; and (3) Not now, but someday. We found that young women’s explanations allowed them to reduce feelings of abnormality and enabled them to distance themselves from sexual expectations regarding the perceived value of orgasm. In analyzing the complicated gender and sexual dynamics surrounding orgasm, we turned to Fahs’ (2014) work on sexual freedom and the importance of articulating freedom from sexual obligations as a key intervention in critical sexuality research. In our discussion, we examine the implications of our findings for critical researchers looking to better understand the role of sexual norms in how young women imagine and discuss the role of pleasure in their own sexual lives.